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26 Cards in this Set
- Front
- Back
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What is the most prevalent viral cause of congenital disease in the US?
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Cytomegalovirus (CMV)
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What is the mode of replication of Cytomegalovirus (CMV)?
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The same as HSV and VZV:
- Glycoproteins bind to cell receptors - Tegument/capsule deposited within cytoplasm - Uses microtubules to move to nucleus, delivers viral DNA - 3 waves of transcription |
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What cells does Cytomegalovirus (CMV) infect?
In what cells does it establish latency? |
- Epithelial, endothelial cells, salivary glands
- Latency in Bone Marrow stem cells, T cells, and Macrophages |
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How is Cytomegalovirus (CMV) spread?
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- Via body fluids (oral, sexual, blood transfusions)
- Organ Transplantation, congenital, perinatal |
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What methods does Cytomegalovirus (CMV) have to evade the immune system?
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- Inhibits complement
- Binds IgG Fc region - Blocks MHC Class I presentation |
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Which immune cells are critical for control of Cytomegalovirus (CMV)?
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CD4 and CD8 T CELLS
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What groups have the highest prevalence of Cytomegalovirus (CMV)?
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Two Peaks:
1. Ages 2-5 2. Young Adults through sex |
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What is the seroprevalence of Cytomegalovirus (CMV) by the age of 60?
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60-80%
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For primary CMV mother infections, what is the overall risk to the fetus?
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- CMV infects fetus 1/2 of time
- 1/3 of infected display symptoms OVERALL: 1/6 (Worse if infection is in early pregnancy) |
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Of those fetuses infected with cytomegalovirus (CMV), how many display symptoms at birth?
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- 5% show symptoms (95% asymptomatic)
- 5% have MICROCEPHALY (small head), small size, eye disease, enlarged liver/spleen |
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What is the primary symptom of CMV seen in those children that develop symptoms at ages 2-5 years?
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15% have hearing deficits
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What symptom of CMV is often observed in young adults?
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Mononucleosis Syndrome
- fever 2-4 wks, atypical lymphocytosis, fatigue, mild hepititis |
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In what 2 types of adult patients can CMV cause serious complications?
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1. Transplant Patients, 1-3 months after transplant - prolonged fever, leukopenia (low wbc), hepititis
2. Advanced HIV patients - Retinitis, GI tract inflammation |
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How is Cytomegalovirus (CMV) diagnosed?
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- Quantitative PCR is preferred test
- Can also do Histology (enlarged cell with basophilic body) - Rapid Antigen Test |
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What is the treatment for Cytomegalovirus (CMV)?
Vaccine? |
- No treatment in normal host
- Ganciclovir/valgancyclovir (inhibits DNA replication) in impaired host - No Vaccine |
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What are the cellular characteristics of Cytomegalovirus (CMV)?
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- Beta-herpesvirus
- enveloped - dsDNA - glycoprotein spikes |
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What are the cellular characteristics of the Epstein-Barr Virus (EBV)?
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- Gamma-herpesvirus
- LYMPHOTROPIC - enveloped - dsDNA - glycoprotein spikes |
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What cell type does Epstein-Barr Virus (EBV) infect?
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- Epithelial cells in the phaynx and tongue (productive infection)
- B CELLS (site of latency) |
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Does the Epstein-Barr Virus (EBV) genome integrate into B Cell genomes?
How many genes are expressed to prevent B cell death? |
- No, it is episomal (same as HSV 1&2)
- 10 genes are expressed to maintain the genome and prevent B cell death |
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- How is Epstein-Barr Virus (EBV) spread?
- What percent of adults are infected in the US? |
- Spread via salivia (kissing disease)
- 90% infected (most asymptomatic) |
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What are the 3 major symptoms associated with Epstein-Barr Virus (EBV)?
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1. Infectious Mononucleosis (youg adults, fever, pharyngitis/lymphadenopathy)
2. Splenomegaly, Hepatitis 3. Oral Hairy Leukoplakia (in advanced HIV infections) |
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What are 5 major Epstein-Barr Virus (EBV) associated malignancies?
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1. Post-transplant lymphoproliferative disorder
2. CNS lymphoma in HIV patients 3. Hodkins Lymphoma 4. Nasopharyngeal carcinoma (China) 5. Burkitt's Lymphoma (Africa) - B cell tumor of the jam |
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What are the 2 CNS infections that Epstein-Barr Virus (EBV) can produce?
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1. Encephalitis
2. Guillain-Barre Syndrome |
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How is Epstein-Barr Virus (EBV) diagnosed?
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- Atypical Lymphocytosis
- Heterophil antibody test (Monospot) - antibodies clump to horse/sheep RBC's - EBV specific antibodies - useful in seeing timecourse of infection |
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What is the treatment for Epstein-Barr Virus (EBV)?
Vaccine? |
- No antiviral therapies
- No vaccine - Rituximab (kills B cells) for post transplant EBV - Steroids to reduce airway obstruction |
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What virus that causes purple macules and tumors is seen in HIV subjects?
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Human Herpes Virus 8
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